Medical Bill Appeal Tracker PDF
Keep a narrow record of each disputed bill, the appeal date, and supporting documents you provided.
Medical bill appeal tracker
Log disputed bills, why you appealed, and what the outcome is.
| Provider Name | Account / Bill Number | Original Amount | Reason for Appeal | Appeal Submitted Date | Supporting Documents Provided | Appeal Status / Outcome | Actions |
|---|---|---|---|---|---|---|---|
Generate a narrow PDF tracker to attach to billing disputes.
🔒 MANDATORY CODEX SAFETY FOOTER (INCLUDE VERBATIM)
Non-Negotiable Guardrails
- Do not modify global layout, header, footer, ads, analytics, or shared components
- Do not import @/components/ui/select or any unverified shadcn components
- Use native HTML inputs only
- Row add/remove buttons must be plain <button>
- No date math, no parsing, no calculations
- PDF builders must return Promise<Uint8Array>
- Always create Blobs using bytesToPdfBlob(bytes) from lib/pdf/bytes.ts
- Never include null in React-PDF style arrays
- No refactors
- Tool may only break itself
Safety notes
- Processing stays in your browser. PDFs generate locally—no uploads or accounts.
- Downloads use a secure PDF blob helper (no raw array buffers or workers required).
- Review details before sending; nothing here is legal advice or a substitute for local forms.